Test Driving the Covered California Website

Thursday, May 29, 2014

The idea originally came from our professor.  She thought that students of healthcare—whether we were to be future clinicians or health policy experts—should experience the trials of finding insurance alongside our eventual patients and clients. 

In theory I agreed.  As a nurse in the ICU my coworkers and I complain when our management has never been “in the trenches” themselves.  Although it sounded tedious and I lacked enthusiasm, I eventually acquiesced. If, someday, one hopes to influence policy such as the Affordable Car Act for the better, it follows that a full understanding of the current system should involve personal experience.

Additionally, there was also the misty future prospect of working for an NGO or some other entity without established health insurance. I might very well be searching for insurance on my own after graduation severs my connection with UCSF’s expensive but thorough health coverage. So I metaphorically girded my loins, which in this case involved gathering up random bits of legal paperwork, and prepared to sign up for Covered California. 

The preparatory work took very little time.  I keep my papers fairly well organized so in less than ten minutes I’d managed to assemble my social security information, tax-return documents from last year, and various medical documents that I thought might be required.  Then on to https://www.coveredca.com/ which is the California branch of the Affordable Care Act’s health exchange website. 

Although it is well past the deadline for signing up this year a friendly banner across the page informed me that it was still worth the attempt, and that many benefits are still available.  I spent some time trolling the Frequently Asked Questions and realized that my quick paper gathering session may not have been adequate. 

Several of the FAQs referenced uploading a birth certificate or a paystub.  I decided to wait and see if I would need them before searching for more esoteric documents. I hit the “Apply Now” button and started off on my journey. 

I filled out multiple pages of information over the course of several minutes.  Since my medical history is fairly simple, being youngish, single, having no chronic diseases and no (known) familial risk factors it was an easy process.  I realized also that those characteristics also made me a desirable customer because the ACA needs plenty of healthy young people paying for insurance in order to pay for those members who would frequently need coverage. 

At the end of the multiple pages my health plan options were finally available.  Although I was curious out of future necessity, I also browsed with an interest in comparing these plans to our current UCSF coverage. Of course there were many options with the ability to pay more bringing more coverage. 

The basic “bronze” level plans offered a lower premium than the UCSF plan, but also came with a high deductible of $5000 which basically meant that I would pay for all medical care during the year since I doubt I would exceed the $5000 and get to part where my care was actually covered.  The silver plan offered were fairly equitable in premiums with the UCSF coverage, but also came with a $2000 deductible to be paid before any coverage kicked in.  For bronze level 30 percent of high cost services (hospital stay, etc.) would fall on the insuree and for silver, 20 percent. 

I was happy to see $6,350 out of pocket maximum cost for both plans, and that certain preventative services were covered for free.  The gold and platinum level plans had much higher premiums, but covered around 90 percent of costs.  Family costs were higher than individual (obviously) and I skimmed over those numbers as well. 

Cumulatively, the time spent gathering papers, applying, and then researching plans had been about an hour.  Although I am happy to stay with my current coverage for now, the information garnered was valuable for the future and had been a fruitful enterprise also in terms of experience gained.  Although I have no horror stories to tell of crashing websites and long wait times (although presumably the wait times would occur after the later steps in applying for a particular plan) I feel the experience broadened my understanding of the Affordable Care Act in California.